Stress: its surprising implications for health

Whether it is down to work pressure, money worries or relationship troubles, most of us experience stress at some point in our lives. In fact, around 75% of us report experiencing moderate to high levels of stress over the past month. It is well known that stress can cause sleep problems, headache and raise the risk of depression. But in this Spotlight, we look at some of the more surprising ways in which stress may harm our health.

Over the past month, around 75% of us have experienced moderate to high levels of stress.

The National Institute of Mental Health (NIMH) define stress as the "brain's response to any demand." In other words, it is how the brain reacts to certain situations or events.

It is important to note that not all stress is negative. Many of us who have been in a pressurized situation may have found that stress has pushed us to perform better. This is down to a "fight-or-flight" response, whereby the brain identifies a real threat and quickly releases hormones that encourage us to protect ourselves from perceived harm.

It is when this fight-or-flight response overreacts that problems arise, and this usually happens when we find ourselves exposed to constant threats.

"Stress is caused by the loss or threat of loss of the personal, social and material resources that are primary to us. So, threat to self, threat to self-esteem, threat to income, threat to employment and threat to our family or our health," Stevan Hobfoll, PhD, the Judd and Marjorie Weinberg presidential professor and chair at Rush University Medical Center in Chicago, IL, and member of the American Psychological Association (APA), told Medical News Today.

Stress levels 'too high' in Americans

In February last year, the APA released their annual "Stress in America" Survey, which assesses the attitudes and perceptions of stress and identifies its primary causes among the general public.

The survey, completed by 3,068 adults in the US during August 2014, revealed that the primary cause of stress among Americans is money, with 72% of respondents reporting feeling stressed about finances at some point over the past month. Of these, 22% said they had felt "extreme stress" in the past month as a result of money worries.

The second most common cause of stress among Americans was found to be work, followed by the economy, family responsibilities and personal health concerns.

On a positive note, average stress levels among Americans have decreased since 2007. On a 10-point scale, respondents rated their stress levels as 4.9, compared with 6.2 in 2007. However, the APA say such levels remain significantly higher than the 3.7 stress rating we consider to be healthy.

"[Last] year's survey continues to reinforce the idea that we are living with a level of stress that we consider too high," says Norman B. Anderson, CEO and executive vice president of the APA, adding:

"All Americans, and particularly those groups that are most affected by stress - which include women, younger adults and those with lower incomes - need to address this issue sooner than later in order to better their health and well-being."

The surprising health implications of stress

"Stress is significantly associated with virtually all the major areas of disease," Prof. Hobfoll told MNT. "Stress is seldom the root cause of disease, but rather interacts with our genetics and our state of our bodies in ways that accelerate disease."

Some of the more well-known implications of stress that many of you may have experienced include sleep deprivation, headache, anxiety and depression. But increasingly, researchers are uncovering more and more ways in which stress can harm our health.

Heart health

According to the American Heart Association (AHA), stress can influence behaviors that have negative implications for heart health.

One study found stress could increase heart attack risk by 23%.

Have you ever arrived home after a stressful day at work and reached for that bottle of wine? Many of us have.

In January 2015, MNT reported on a study that found working long hours was associated with risky alcohol use, which the study researchers say is partly down to the belief that "alcohol use alleviates stress that is caused by work pressure and working conditions."

Some of us may smoke in response to stress, while others may "comfort eat," which can lead to obesity. All of these are factors that can contribute to poor heart health by raising blood pressure and causing damage to the walls of the arteries.

According to a study reported by MNT in November 2014, stress may also reduce blood flow to the heart - particularly for women. The study researchers found that in patients with coronary heart disease, stressed women had a three times greater reduction in blood flow than stressed men.

Periods of stress increase production of the hormone cortisol, which can increase the amount of glucose in the blood - a potential explanation for why stress has been linked to higher risk of diabetes.

For people who already have diabetes, stress can lead to poorer management of the condition. As well as interfering with stress hormones and increasing blood glucose levels, the American Diabetes Association note that stressed patients with diabetes may be less likely to take care of themselves.

"They may drink more alcohol or exercise less. They may forget, or not have time, to check their glucose levels or plan good meals," states the organization.

Alzheimer's disease

Alzheimer's disease affects more than 5 million people in the US and is the sixth leading cause of death in the country.

While the exact causes of the condition are unclear, past studies have suggested that stress may contribute to its development.

A study found that for seniors with mild cognitive impairment, anxiety could speed up progression toward Alzheimer's.

In March 2013, MNT reported on a study by researchers from the University of Gothenburg in Sweden, which found high levels of stress hormones in the brains of mice were associated with larger amounts of beta-amyloid plaques - proteins believed to play a role in Alzheimer's.

Another study published in 2010 by Finnish researchers found that women who had either high blood pressure or higher cortisol levels - both symptoms of stress - were more than three times as likely to develop Alzheimer's, compared with patients who did not have these symptoms.

In 2012, the UK's Alzheimer's Society revealed they are embarking on a 3-year project to find out more about the association between stress and Alzheimer's disease.

"All of us go through stressful events. We are looking to understand how these may become a risk factor for the development of Alzheimer's," said lead investigator of the project Prof. Clive Holmes, of the University of Southampton in the UK.

Fertility

Approximately 1 in 8 couples in the US have problems getting pregnant or sustaining a pregnancy. Increasingly, researchers are suggesting stress may be a contributing factor.

In May 2014, we reported on a study published in the journal Fertility and Sterility that found stress in men can lead to reduced sperm and semen quality, which may negatively affect fertility.

The researchers behind that study, including first author Teresa Janevic, PhD, an assistant professor at Rutgers School of Public Health in Piscataway, NJ, hypothesize that stress could trigger the release of glucocorticoids - steroid hormones that affect the metabolism of carbohydrates, fats and proteins. This could lower testosterone levels and sperm production in men.

"Stress has long been identified as having an influence on health," says Janevic. "Our research suggests that men's reproductive health may also be affected by their social environment."

And women may not be free from the effects of stress on fertility. In 2014, a study led by researchers from Ohio State University found that women with high levels of a stress-related enzyme in their saliva - alpha-amylase - were 29% less likely to become pregnant than women with low levels of this enzyme. What is more, these women were also more than twice as likely to be infertile.

How can you protect against stress-induced health problems?

Of course, the best way to reduce the risk of stress-related health implications is to tackle the stress itself.

In order to do this, you first need to recognize the symptoms of stress. Though these vary in each individual, they commonly include difficulty sleeping, fatigue, overeating or undereating and feelings of depression, anger or irritability. You may also be smoking or drinking more in an attempt to manage stress, and some people many even engage in drug abuse.

According to the NIMH, one of the best ways to tackle stress is to seek support from others, be it friends, family or religious organizations. If an individual feels they are unable to cope with stress, are having suicidal thoughts or has engaged in drug or alcohol use to try and manage stress, the organization recommends they seek help from a qualified mental health provider.

Exercise can also be an effective aid for stress. The Mayo Clinic explain that physical activity increases production of "feel-good" neurotransmitters in the brain, called endorphins. Exercise has also been associated with reduced symptoms of depression, as well as improved sleep quality.

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Comments(2)

I suggest the basis of stress-induced and lack of / disrupted sleep-induced problems, that are so pervasive in our pathological conditions, all are caused by disruptions in our production of dehydroepiandrosterone (DHEA).

It is my hypothesis that evolution selected DHEA because it optimizes replication and transcription of DNA, that is, genes. Therefore, DHEA levels affect all tissues and all tissues compete for available DHEA, especially the brain. (I think evolutionary selection of DHEA produced mammalia. “Hormones in Mammalian Evolution,” Rivista di Biologia / Biology Forum 2001; 94: 177-184). DHEA naturally begins to decline around the ages of twenty to twenty-five, reaching very low levels in old age. When DHEA is low or decreasing, all tissues and genes are adversely affected according to a natural competition for available DHEA between tissues / genes.

DHEA participates in gene function; DHEA participates in everything from basic physiology to behaviorally-induced phenomena including touch and simply “seeing” those things that affect us from lovers to food. Meditation increases DHEA.

There is an evolutionary basis to all of this. It is my hypothesis that mammals evolved because of selection for DHEA. (Hormones in Mammalian Evolution, Rivista di Biologia / Biology Forum 2001; 94: 177-184 ) This is based on my hypothesis that evolution selected DHEA because it optimizes replication and transcription of DNA. DHEA affects expression of genes. Therefore DHEA levels affect all tissues and the life span. A case may be made that optimal amounts of DHEA are necessary for conception. Since a mother produces DHEA for herself and her fetus, she must have an optimal level of DHEA for conception and maintenance of a fetus until near birth when fetal production of DHEA combines with the mothers DHEA to signal and initiate birth. Selection pressure within Mammalia for testosterone produced primates and, with exaggeration, humans. I think testosterone increases cellular absorption of DHEA by increasing androgen receptors through which DHEA enters cells. The selection is basically selection for additional cellular DHEA because of testosterone. (If you, et al., desire more detail of this: DHEA, Estradiol, Testosterone, and the Relevance of Their Ratio The Androgen Receptor and the Secular Trend, at: http://anthropogeny.com/Androgen%20Receptor%20and%20Secular%20Trend.html .)

Regarding stress, cortisol is the product of stress. It is my hypothesis that cortisol evolved to counteract the effects of DHEA and is the basis of the “fight or flight” mechanism. (“A Theory of the Control of the Ontogeny and Phylogeny of Homo sapiens by the Interaction of Dehydroepiandrosterone and the Amygdala,” Copyright 1985, James Michael Howard, Fayetteville, Arkansas, U.S.A. (Registered Copyright TXu220580).) The “cortisol to DHEA ratio” appears numerous times in the medical literature; it is becoming an important mechanism.

Aging, the loss of DHEA, exposes genes that function under the influence of optimal levels of DHEA but malfunction as DHEA decreases. These include “early onset” diseases that appear early in aging. Optimally functioning genes begin to malfunction with the loss of DHEA of “normal” aging. These include “late onset” diseases that appear in the very healthy but appear anyway with aging.

Interesting hypothesis and at least part of it should/will withstand the test of test. But, the more direct root of the problem is the "three sisters" themselves; the stress hormones that wreck havoc on our bodies and our minds throughout our lives, if left unchecked.
It's the 800 pound gorilla in the room that the medical model tries to ignore at best and, at worst, tries to subdue with drugs. However, I would hypothesize that, once we are being diagnosed by computers-in 5/10 years-that don't have the medical biases and blind spots of our current medical providers, the role of stress will come to be understood as the preeminent cause of most illnesses. Genes and bad luck will be present as well, but the focus will be on "bad" stress-distress.

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